Assessment and management of haematuria in the general practice setting

The presence of haematuria may be a singular symptom signalling underlying urological pathology, either benign or malignant. However, a large proportion of patients with haematuria will have no identifiable cause found. Appropriate early investigation and management of haematuria in the primary care setting is important for timely referral of patients suspected of having serious underlying pathology while avoiding over-investigation in those patients prone to transient and benign causes.

The aim of this article is to provide a summary of the aetiology, investigation and management of haematuria in the primary care setting, with a focus on urological assessment and outcomes.

The approach to the diagnosis and investigation of haematuria differs depending on whether the haematuria is macro- or microscopic. In both cases, clinicians should begin by obtaining a careful patient history to include specific risk factors for urological malignancy, as often the decision for further work-up requires a risk-stratified approach.